Information Collection

Annual Information Return/Report of Employee Benefit Plan

IC 13467 under ICR 202112-1210-003 · OMB 1210-0110.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0110 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2021 Form 5500-EZ Instructions Clean.docx	Instruction
2021 Form 5500 Instructions 122721.pdf	Instruction
2021 Form 5500SF Instructions 122721.pdf	Instruction
Form 5500 Annual Return/Report of Employee Benefit Plan 201209 Form 5500 Clean.docx	Form
Form 5500-SF Short Form Annual Return/Report of Small Employee Benefi 201209 Form 5500-SF Clean.docx	Form
Form 5500 Schedule Insurance Information 201209 Sch A Clean.docx	Form
Form 5500 Schedule Service Provider Information 201209 Sch C Clean.docx	Form
Form 5500 Schedule DFE/Participating Plan Information 201209 Sch D Clean.docx	Form
Form 5500 Schedule Financial Transaction Schedules 201209 Sch G Clean.docx	Form
Form 5500 Schedule Financial Information 201209 Sch H Clean.docx	Form
Form 5500 Schedule Financial Information--Small Plans 201209 Sch I Clean.docx	Form
Form 5500 Schedule Multiemployer Defined Benefit Plans and Certain Money Pu 201209 Sch MB Clean.docx	Form
Form 5500 Schedule Single-Employer Defined Benefit Plan Actuarial Informati 201209 Sch SB Clean.docx	Form
Form 5500 Schedule Retirement Plan Information 201209 Sch R Clean.docx	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Annual Information Return/Report of Employee Benefit Plan

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2520.103-1

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Form 5500	Annual Return/Report of Employee Benefit Plan	201209 Form 5500 Clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500-SF	Short Form Annual Return/Report of Small Employee Benefit Plan	201209 Form 5500-SF Clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule A	Insurance Information	201209 Sch A Clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule C	Service Provider Information	201209 Sch C Clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule D	DFE/Participating Plan Information	201209 Sch D Clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule G	Financial Transaction Schedules	201209 Sch G Clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule H	Financial Information	201209 Sch H Clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule I	Financial Information--Small Plans	201209 Sch I Clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule MB	Multiemployer Defined Benefit Plans and Certain Money Purchase Plan Actuarial Information	201209 Sch MB Clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule SB	Single-Employer Defined Benefit Plan Actuarial Information	201209 Sch SB Clean.docx	Yes	Yes	Fillable Fileable Signable
Form	Form 5500 Schedule R	Retirement Plan Information	201209 Sch R Clean.docx	Yes	Yes	Fillable Fileable Signable
Instruction			2021 Form 5500-EZ Instructions Clean.docx	Yes	Yes	Fillable Fileable
Instruction			2021 Form 5500 Instructions 122721.pdf	Yes	Yes	Fillable Fileable
Instruction			2021 Form 5500SF Instructions 122721.pdf	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 840,923

Number of Respondents for Small Entity: 683,359

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	840,923	18,789	0	822,134
Annual IC Time Burden (Hours)	3,031,649	2,313	2,443,022	586,314
Annual IC Cost Burden (Dollars)	0	0	-280,700,898	280,700,898

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.